Thorax:曲霉菌与囊性纤维化患儿肺疾病进展

2018-10-04 xing.T MedSci原创

由此可见,在患有囊性纤维化的儿童中,5岁时阳性的曲霉BAL培养物与空气诱捕同时不伴有支气管扩张相关。然而,阳性曲霉BAL培养物与5岁时预测的FEV1%或5岁至14岁之间肺功能下降之间未观察到关联。

曲霉菌对囊性纤维化幼儿肺疾病的影响尚不确定。近日,胸部疾病领域权威杂志Thorax上发表了一篇研究文章,研究人员旨在明确曲霉菌培养阳性的呼吸道疾病是否与以下因素有关:(1)5岁时结构性肺损伤加重; (2)5岁至14岁之间肺功能加速下降,(3)确定解释变量。

研究人员对来自澳大利亚囊性纤维化支气管肺泡灌洗(ACFBAL)研究的受试者进行曲霉菌阳性支气管肺泡灌洗(BAL)培养与5岁时胸部高分辨率CT(HRCT)扫描结果之间关联的横断面分析。使用来自ACFBAL研究中受试者5岁时和来自澳大利亚囊性纤维化数据登记处6-14岁受试者的FEV1%预测值开发了非线性混合效应疾病进展模型。

5岁时阳性曲霉BAL培养物与空气诱捕的HRCT评分显著相关(OR为5.53,95%CI为2.35~10.82)。然而,调整体重指数z-评分和继发于肺部恶化的住院治疗后,阳性曲霉菌培养物与5年时预测的FEV1%或年龄预测的FEV1%无关。这类人群中肺功能呈现非线性下降。

由此可见,在患有囊性纤维化的儿童中,5岁时阳性的曲霉BAL培养物与空气诱捕同时不伴有支气管扩张相关。然而,阳性曲霉BAL培养物与5岁时预测的FEV1%或5岁至14岁之间肺功能下降之间未观察到关联。

原始出处:

Sabariah Noor Harun,et al.Aspergillus and progression of lung disease in children with cystic fibrosis.Thorax. 2018. https://thorax.bmj.com/content/early/2018/10/01/thoraxjnl-2018-211550

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    2018-11-08 wolongzxh
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